Anatomy Flashcards
1)Triangles of the neck
2) Structures within triangles
1) Anterior - Horizontal ramus of mandible, Midline, SCM
Posterior - middle 1/3 Clavicle, trapezius, SCM,
Roof - Investing Fascia
Floor - Prevertebral fascia
2) Anterior -
Muscles - Supra + (Stylohyoid, digastric, myohyoid, geniohyoid) Infra (Omohyoid, sternohyoid, sternothyroid, thyrohyoid) hyoid muscles
Vascular - CCA, Carotid bifurcation, IJV
Nerves- VII, IX, X, XI, XII
Posterior -
Muscles - Omohyoid (Inferior belly), Vertebral muscles (scalenes, splenius, capitis, levator scapulae)
Vascular - EJV (empties into SCV), Subclavian Art (between ant. and mid. scalen) + Vein, Transverse Cerv. Art + Vein, Suprascapular ARt + Vein
Nerves - CN XI, Cervical Plexus, Phrenic Nerve, Brachial Plexus
1) Subdivisions
2) Contents
1) Carotid - Posterior belly of digastric, Medial border of SCM, Superior belly of omohyoid
Submental - midline, Anterior belly of digastric, hyoid bone
Submandibular - Anterior belly of digastric, Posterior belly of digastric, mandible
Muscular - Hyoid, omohyoid + SCM, Midline
2)
Muscles - Supra + (Stylohyoid, digastric, myohyoid, geniohyoid) Infra (Omohyoid, sternohyoid, sternothyroid, thyrohyoid) hyoid muscles
Vascular - CCA, Carotid bifurcation, IJV
Nerves- VII, IX, X, XI, XII
1) Subdivisions
2) Contents
1) Occipital Triangle- SCM, trapezius, Inf. belly of omohyoid
Subclavian triangle - SCM, mid 1/3 clavicle, Inf. belly of omohyoid
2)
Muscles - Omohyoid (Inferior belly), Vertebral muscles (scalenes, splenius, capitis, levator scapulae)
Vascular - EJV (empties into SCV), Subclavian Art (between ant. and mid. scalen) + Vein, Transverse Cerv. Art + Vein, Suprascapular ARt + Vein
Nerves - CN XI, Cervical Plexus, Phrenic Nerve, Brachial Plexus
Suprahyoid Muscles
Name them, their attachments and innervation
1) Stylohyoid
Styloid process of temporal bone –> lateral hyoid
Innervated by a branch of CN VII
2) Digastric
2 bellies.
Anterior (Inferior Alveolar Nerve - CNV3) - digastric fossa of mandible.
Posterior (Facial Nerve) - styloid process of temporal bone.
Two bellies communicate via intermediate tendon which is trapped by a fibrous sling on thy hyoid bone.
3) Mylohyoid
Mylohyoid line of mandible –> hyoid bone.
Innervation from Inferior Alveolar Nerve of CNV3
4) Geniohyoid
Mental spine of mandible –> hyoid bone
C1 Nerve roots (Travel with CNXII)
Infrahyoid Muscles
name them, their attachments and their innervations
Blood supply from Sup. + Inf. Thyr. Arteries
DEEP
1) Thyrhoyoid
Thyroid cartilage –> hyoid bone
Innervated C1 (travels within CNXII)
2) Sternothyroid
Manubrium –> thyroid cartilage
Innervated by Ansa Cervicalis (C1-C3)
SUPERFICIAL
3)Sternohyoid
Sternum/SCJ –> hyoid bone
Innervated by Ansa Cervicalis (C1-C3)
4) Omohyoid
Scapula (Inferior belly) –> hyoid (superior belly) via intermediate tendon anchored to deep cervical fascia
Innervated by Ansa Cervicalis (C1-C3)
Submandibular Gland
1) Structures at risk during excision + deficit
2) Innervation
1) Lingual Nerve - Ipsilateral taste / sensation loss of anterior 2/3 tongue
Hypoglossal Nerve - Ipsialteral paralysis of the tongue
Facial Nerve (marginal Mandibular branch) - Ipsilateral weakness of lower lip and chin
2) Parasympathetic - CNVII –> Chorda tympani –> Then travels with lingual nerve before synpasing at submandibular ganglion. More volumous secretions
Sympathetic - Superior Cervical Ganglion then plexus follows arteries. Less volumous more enzyme rich secretions.
1) Extrinsic Muscles (attachments + Innervations)
2) Intrinsic Muscles (Innvervations)
1) Extrinsic:
Genioglossus - Mandible –> Hyoid (+all of tongue)
Innervated by CN XII
Hyoglossus - Hyoid –> tongue (CN XII)
Styloglossus - Styloid process –>tongue (CNXII)
Palatoglossus - Palatine aponeurosis –> tongue (CNX)
2) Intrinsic Muscles
Superior longitudinal, inferior longitudinal, transverse + vertical
All innervated by CNXII
Muscles attaching at 1-8
Ligaments 9-11
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1 - Suprapinatous 2 - subscapularis 3 - Biceps (short) + Corachobrachialis
4 - Pec Minor 5 - Omohyoid 6 - Serratus Anterior
7 - Subscapularis 8 - Triceps (long)
9 - Coracohumeral ligament 10- coraco-acromial ligament 11 - suprascapular ligament
Muscles 1 -14
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ligament 15
1. Infraspinatous 2. Levator Scapulae
3. supraspinatous 4. Trapezius 5. Deltoid
6 Supraspinatous 7 Infraspinatous 8 Teres Minor
9 Long head triceps 10+11 - Teres Minor
12 - Teres Major 13 - Lat Dorsi 14 - Rhom. Major
15. Inferior Scapular Ligament
1) Long head biceps
2) Trapezius (Attach/Innervation)
3) Lat Dorsi (Attach/Innervation)
4) Levator Scapulae (Attach/Innervation)
5) Rhomboids (Attach/Innervation)
1) Supraglenoid tubercle travels within the capsule
2) Skull, nuchal ligament + C7-T12 Spinous processes –> Acromion, Scapular spine + clavicle
Accessory Nerve
3) Spinous Processes T7-T12, iliac crest, inferior three ribs + lumbar fascia –> Intertubercular sulcus of humerus
Thoracodorsal nerve
4) C1-C4 spinous processes –> Medial scapular border.
Dorsal Scapular Nerve
5) C7-T1(Minor) T2-T5 (major) –> medial scapula
Dorsal scapular nerve
1-9
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1. Piriformis 2. glut. max 3. Quadr. Femori
4- origin of semitendinosus, biceps femoris
5 - gracilis 6 - semitendinosus 7. semimembranosus
8. Gracilis 9. Long head of biceps femoris
10-19
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10. Sciatic Nerve 11 Post. Cutaneous Nerve of thigh
12 ischial tuberosity 13 poplit. artery
14. polit. vein 15. SSV
16. Tibial Nerve 17. Common peroneal Nerve
18. Peroneal communicative nerve 19. sural nerve
1-15
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1. Piriformis 2. Quadratus Femoris
3. Origin of semitendinosis/ bicep fem. 4. Gracilis
5. Long head bicep fem. 6 Semitendinosis
7. Short head bicep fem. 8. Semimebranosous
9. Post. Cut. Nerve of thich 10. Sciatic Nerve
11. Ischial Tuberosity 12. Pop. ARt.
13. Pop. Vein 14. Srural Nerve 15. SSV
Name all muscles, attachment and innervation of anterior thigh
Blood Supply
Sartorius - ASIS –> Medial tibia (pes anserius) femoral nerve
Pectineus - Anterior pelvis (pectineal line) –> posterior femur (pectineal line) femoral/obturator nerve
Psoas Major - Lumbar vertebrae has common tendon with iliacus –> lesser trochanter of femur (L1-L3 nerve roots)
Iliacus - Iliac fossa has a common tendon with psoas maj. —> lesser trochanter of femur (femoral nerve)
Quadriceps Muscles: (common insertion onto patella via quadriceps tendon) femoral nerve
Rectus Femoris - Ridge of iliac portion of acetabulum (superior to acetabulum)/ anterior inferior iliac spine
Vastus Medialis - Intertrochanteric line/medial linea aspera
Vastis intermedius - Anterior/Lateral Femoral Shaft
Vastus Lateralis - Greater trochanter/lateral linea aspera
Profunda Femoris
Name all muscles, insertions and innervations of the posterior thigh
Blood Supply
Hamstrings -
Biceps Femoris -
Long head - Ischial tuberosity. tibial portion of sciat.
Short head - Linea aspera. fibular portion of sciat.
Common tendon inserts to head of fibula
Semitendinosus - ischial tuberosity to medial tibia. tibial portion of sciat.
Semimembranosus (deep to semitend.) - ischial tuberosity to medial tibial condyle. tibial portion of sciat.
Blood Supply - Inferior gluteal artery + profunda femoris artery
Name all muscles, insertions and innervations of the medial thigh
Blood Supply
Adductor Magnus
Adductor port. - Inferior pub. rami + ischial rami –> linea aspera. obturator nerv.
Hamstring portion - Ischial tub. –> extends distally attaching to supracondylar line of fem. + adductor tubercle. tibial port. of sciatic n.
Adductor Longus -Pubis –>linea aspera. obturator n
Adductor Brevis (beneath longus)- pubis + inf. pubic rami –> linea aspera (prox. to longus) obtur. nerv.
Obturator Externus - obturator foramen –> post. aspect of greater. troch. obturator nerve
Gracilis - pubis + inf. pub. rami –> pes anserius (in between sartorius and semintendinosis) obturator nerve.
Blood supply - Obturator artery + perforating branches of the profunda femoris
1-11
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1. Pec Minor 2. deltoid 3. Pec major
4. Triceps 5. Biceps (long) 6. Biceps (short)
7. Corachobrachialis 8. Teres Major 9. Subscapularis
10. Lat. Dorsi 11. Serrat. Ant.
12- 19
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12. lat 1/3 clavicle 13. Axillary Vein.
14. Thoracoacromial Trunk
15. Circumflex scapular artery
16. Subscapular Art. 17. Axillary Artery
18. Thoracodorsal artery 19. Brachial Art.
20-28
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20 - Medial Cord 21 - Lateral Cord
22- Musculocutaneous n. 23 - Median n.
24 - Radial n.
25. thoracodrosal n. 26. median n.
27. Ulna N. 28. Medial cutaneous n. of forearm
i) Gross heirarchy
ii) Describe formation from spinal cord to the plexus
iii) Describe derivatives of trunks
iv) Describe contributions to the cords and relative positions
i) Roots > Trunks > Divisions > Cords > Branches
ii) Derived from anterior rami of C5-T1 spinal nerves. They pass in between the anterior and medial scalene muscles just superior to the subcalvian artery
iii) Superior - C5-C6
- *Middle** - C7
- *Inferior -** C8-T1
Trunks cross laterally through the posterior neck triangle
iv) Cords are named relative to axillary artery. Trunks divide into ant. and post. divisions and enter axilla.
Lateral - Anterior Division of Superior + Middle Trunk
Posterior - Posterior Division of all trunks
Medial - Anterior Division of Inferior Trunk
Brachial Plexus 2
i) Major Branches of the brachial plexus
ii) Minor branches of the brachial plexus and where they come from
i)
Lateral Cord - Musculocutaneous Nerve (C5-C7)
Posterior Cord - Axillary Nerve (C5-C6), Radial Nerve (C5-T1)
Medial Cord - Ulnar Nerve (C8-T1)
Medial + Lat. Cords - Median Nerve (C5/6-T1)
ii)
Roots - Dorsal Scap. Nerv (C5 - Rhomboids)
Long Thor. Nerve (C5-7 - Serratus Ant.)
Trunks - Suprascap. Nerv. (Upper Trunk- Supra+ Infraspinatus)
Nerve to Subclavius (Upper Trunk - subclavius)
Lat. Cord - Lat. Pect. Nerv. (Pec Major)
Med. Cord - Med. Pect. Nerv (Pec Min. + Maj)
Med. Cut. Nerve of forearm
Med. Cut. Nerve of arm
Post. Cord - Thoracodorsal Nerv. (Lat. Dorsi)
Sup. Subscapular Nerv. (subscapularis)
Inf. Subscapular Nerv. (Teres Maj. + subscapularis)
The Axilla:
i) Boundaries
ii) Passageways exiting the axilla
iii) Contents of axilla
i)
Apex - Posterior clavicle, Sup. Scapula, First Rib
Latera- Intertubercular groove of humerus
Medial - Serratus anterior + thoracic wall
Posterior - lat dorsi, teres maj., subscapularis
anterior - pec major, minor, subclavius
ii)
1) Exit into upper arm (Lat. and inf.)
2) Qaudrangular Space
Lat. - Humerus, Med. - Triceps long head, sup. - teres minor. inf. - teres major
Transmits - Axillary n., post circumflex humeral vessels
3) Clavipectoral Triangle
Inf - pec Major Sup Lat. - Deltoid, Sup Med. - Clavicle
Transmits - Cephalic Vein, Deltoid branch of thoracoacromial art.
4) Lateral Triangular Space
Sup - Teres Maj Lat - Humerus med - Long head triceps
Transmits - Radial Nerve, Pronfuda brachii artery
iii) Axillary Contents:
- Axillary artery + branches
- Axillary veins + tributaries
- Axillary LNs
- Biceps (short) head, and corachobrachialis
Subclavian Artery
i) Gross route
ii) Branches
i) R- arises from brachiocephalic trunk. RLN winds around this on the right side
L - Directly from aortic arch
1st part - Aorta –> Anterior Scalene
2nd part - Posterior to anterior scalene
3rd part - Anterior scalene to first rib
ii) VIT CD
1st -
Vertebral (Enter C6 transverse process travelling superiorly through foramen transversarium before enterring foramen magnum where they unite)
Internal Thoracic Artery (Intercostal branches, breast perforators, terminates as superior epigastric)
Thyrocervical trunk ( Inferior thyroid, Suprascapular, transverse cervical art.)
2nd - Costocervical Trunk (Sup. intercosta, deep cervical)
3rd Dosal Scapular Artery
Axillary Artery
i) Gross Route
ii) branches
i) Continuation of subclavian art. as it passes border of first rib. beomes the brachial artery after the lower border of teres major
Divisible into three parts
1st part - Proximal to pec minor
2nd part - Posterior to pec minor
3rd part - Distal to pec minor
ii) Screw the Lawyer, Save a patient
1st part - Superior Thoracic Artery
2nd part - Thoracoacromial artery (Pectoral, Acromial, Clavicular + Deltoid)
Lateral Thoracic Artery
3rd Part - Subscap. art.
Ant. + Post. Circumflex arteries
Ear
i) Middle Ear Muscles
ii) Parasympathetic Nerves running through/near ear
i) Tensor Tympani - Auditory tube –> handle of malleus
Mandibular Nerve V3
Dampens sounds
Stapedius - Pyramid walls –> Stapes
VII
Stabilises of stapes
ii) CNVII - Parasympathetic nerves to lacrimal glands.
Gives off the greater petrosal nerve to the pterygopalatine ganglion. From here postganglionic fibers travel with V2 branches to reach nasolacrimal glands/epithelium.
Gives off the chorda tympani (joins lingual nerve) which synapses with the submandibular ganglion and innervates submandibular gland.
CNIX - Tympanic branch innervates tympanic plexus. CNIX fibers then form lesser petrosal nerve synapsing with the otic ganglion. postganglionic fibers then travel with auriculotemporal nerve (V3 Branch) to innervate parotid + sublingual glands.
Label 1-13
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1. Helix 2. Scapha 3. Tubercle 4. Antihelix
5. Antitragus 6. Earlobe 7. Tragus
8. Intertragic Notch 9. External Meatus (cartilage)
10. Crus of helix 11. Crus of antihelix
12. Triangular fossa 13. Mastoid Process
Label 14-25
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14. Mallues 15. Incus 16. Stapes
17. Manubrium 18. Malleus 19. Pars Flaccida
20. Chorda Tympani 21. Incus 22. Umbo
23. Pars tensa 24. Annulus Fibrosis 25. cone of light
Grossly Describe External Ear
i) Visible
ii) Describe external accoustic meatus
iii) Tympanic Membrane
iv) innervation of the external ear
i) Auricle - Visible part of the ear.
Upper auricle is cartilagenous while the lobe is not cartilagenous.
Helix is the outer cartilagenous rim of auricle while the anti-helix is the inner cartilagenous rim
Concha- Depression in middle ear continuing into the external accoustic meatus
Tragus and anti-tragus - immediately at entry to the external accoustic meatus
ii) External accoustic meat. runs from concha to the tympanic membrane in an s shape. external 1/3 - cartilaginous whereas the internal 2/3 are formed by the temporal bone
iii) Tympanic memb. - Connected to temporal bone by fibrocartilagenous ring.
Handle of malleus attaches at umbo. Pars tensa spreads radially from the handle of malleus whereas pars flacidda is superior to the handle
iv)
Cervical Plexus - Greater auricular nerve + Lesser occipital nerve both supply skin of auricle
Auriculotemporal nerve (CNV3), Facial Nerve + Vagal nerve supply skin of auricle and external accoustic meatus
Middle Ear
i) Gross Description
ii) Borders
iii) Bony components
i) Begins at tympanic membrane. Medially is the tympanic cavity whereas superiorly is the epitympanic recess (next to the mastoid air cells)
Eustachian tube connects middle ear (ant. wall) to nasopharynx (lat. wall).
ii)
Roof - Petrous temporal bone adjacent to middle cranial cavity
Floor - Petrous temporal bone. IJV adjacent
Lateral wall- Tympanic Membrame
Medial wall - Laterally borders inner ear. Facial Nerve Bulge
Anterior Wall - Two openings - Auditory tube + tensor tympani. ICA adjacent
Posterior Wall - Adjacent to mastoid cavity. Mastoid aditus allows communciation between middle ear and mastoid air cells
iii) Bony components transmit sound from tympanic membrane to the oval window
Malleus–> Incus–> Stapes
INner Ear
i) Gross anatomy
ii) Describe balance organs
iii) Describe auditory organs
i) Grossly the inner ear is comrpised of the
- bony labyrinth, in the petrous bone formed by cochlea, vestibule (cochlea is anterior and semi circular canals are posterior) and 3 semi-circular canals. Lined by perilymph
- membranous labyrinth is within the bony labyrinth. It is formed from saccule, 3 semi-circular ducts, cochlea duct and utricle. Lined by endolymph
-
oval window is between middle ear and vestibule, round window is betwene the middle ear and part of the cochlear duct
iii) Cochlea houses the cochlea duct. Modiolus is central portion of bone in cochlea which communicates with CN VIII. Spiral Lamina portion of cochlea holds teh cochlea duct in place.
Scala vestibuli superior to each cochlea duct (seperated from each other by reissner’s membrane) and scala tympani inferiorly (seprated by basilar membrance which houses organs of corti [specialised accoustic epithelium]). Basement membrane essentially are the receptors of CNVIII.
iii) Saccule and Urticle in the vestibule responsible for balance. saccule - vertical movement recevies the cochlea duct. urticle -horizontal movement receives the semicircular ducts.
Submandibular Gland 1
i) Location
ii) (Once again) What is at risk during surgery
iii) relation of facial artery and vein to submandibular gland
i) Posterior inferior to horizontal mandibular ramus in digastric triangle.
ii) Marginal Mand. Nerve (Lip droop), Lingual Nerve,
Hypoglossal Nerve
iii) Artery- passes deep to the gland
vein - passes superficial to the gland
Submandiublar 2
1-12
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1. Frontalis 2. Obicularis Oculi 3. Temporalis
4+5. Levator Labii Superioris 6. Orbicularis Oris
7. Levator Angular Oris 8. Zyg. Major
9. buccinator 10. Depressor anguli Oris
11. Depressor Labii Inferioris 12. masseter
Submandibualr 3
13-25
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13. parotid gland 14. submandibular gland
15. Horizontal body of mandible
16. Facial Artery 17. Sup. Temp. Artery
18. Angular Vein 19. Facial Vein 20. IJV
21. Stenson’s (parotid) duct 22. Temporalis Fascia
23. Facial nerve (upper div.)
24. VII Buccal branches 25. VII Zyg. Branches
The Nose
1-12
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1. Frontal Bone 2. Nasal Bone 3. Superior Concha
4. Sphenoid Sinus 5. Pituitary GLand
6. Middle Meatus 7. Hiatus Semilunaris
8. inferior Conchae 9. inferior meatus
10. nasopharynx 11. tubular ridge
12. opening of eustachian tube
The nose
13
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13. Adenoid 14. Pharyngeal Recess
15. Salpingopharyngeal fold 16. Pharyngeal isthmus
17. Hard palate 18. Soft palate
19. oral cavity 20. oropharynx
21. palatopharyngeal fold 22. Palatoglossal fold
23. Intrinsic tongue muscles 24. Nares
The nose
1-20
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1. inferior meatus 2. inferior conchae
3. Hard palate 4. soft palate 5. Pharyngeal isthmus
6. palatopharyngeal fold 7. palatoglossal fold
8. oral cavity 9. Fungiform papillae
10. Vallate papillae 11. oropharynx 12. lingual tonsils
13. intrinsic tongue muscles 14. Genioglossus
15. geniohyoid 16. epiglottis 17. piriform fossa
18 Vallecular 19. hyoid bone 20 laryngeal inlet
Broad divisions of oral/ nasal cavity:
1) Nasal Cavity
2) Nasopharynx
3) Oral cavity
4) Oropharynx
5) Laryngopharynx
1) Nares–> imaginary line through start of soft palate and base of skull
2) Ends at a line drawn between uvula (end of soft palate and base of skull)
3) Lips to level of anterior epiglottis
4) Anterior border - Line between uvula and anterior epiglottis
Superior - level of uvula
inferior - level of hyoid bone
5) hyoid bone to the level of trachea/oesophageal divergence
Oropharynx
1-13
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1. Pituitary Gland 2. sphenoid Sinus
3. Middle Concha 4. Adenoids 5. Nasopharynx
6. Auditory Tube Opening 7. Pharyngeal recess
8. tubal ridge 9. salpingopharyngeal fold
10. Soft palate 11. Uvula/pharyngeal isthmus
12. palatoglossal fold 13. palatopharyngeal fold
Oropharynx
14-26
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14. Oropharynx 15. Post. Pharyng. Wall
16. Lingual Tonsil 17. Epiglottis
18. Laryngopharynx 19. Hyoid Bone
20. Vestibular Fold (false cords) 21. Laryng. Sinus
22. Vocal Fold (true cord) 23. Trachea
24. Oesophagus 25. Retropharyngeal Space
26. Piriform fossa
Oropharynx
27-38
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27. Anterior arch of atlas 28. Dens 29. C3 Body
30. Basilar ARt. 31. Vertebral art. 32. PICA
33. Pons 34. medulla oblongata 35. Cerebellum
36. 4th Ventricle 37. Cisterna Pontis
38. Central Canal
Anterior Neck Anatomy
1-14
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1. Parotid Gland 2. Submandibular Gland
3. masseter 4. Platysma 5. Mylohyoid
6. Anterior Belly Digastric 7. Posterior belly digastric
8. Hyoid Bone 9. Omohyoid (Sup. Belly)
10. Sternohyoid 11.thryohyoid12. SCM
13. Clavicle 14. Deltoid
Anterior Neck Anatomy 2
15 - 30
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15. Pec Major 16. Scal. Ant. 17. Scal. Med
18. Inf. belly Omohyoid 19. Levat. Scapul.
20. Semispinal. 21. Facial nerv. 22. Int. Jug Vein
23. Ansa Cervicalis 24. EJV
25. Carotid Sinus 26. ICA + ECA
27. Hypoglossal N. 28. Accessory N.
29. subscapular art. 30. Thyrohyoid Nerve.
What covers the roof + floor of the anterior neck triangle
Roof - Investing fascia
Floor- Visceral Fascia
Larynx
i) Cartilage types in the larynx
i) Epiglottis - Elastic
Thyroid, Cricoid, Aryetonoids, corniculate, cuneiform –> Hyaline
Larynx anatomy
1-9
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1. Fungiform Papillae 2. Vallate Papillae
3. Foramen Caecum 4. Sulcus Terminalis
5. epiglottis 6. laryngeal inlet
- *7.** valleculae 8. Posterior Pharyngeal Wall
- *9.** Piriform Fossa
Larynx Anatomy 2
10-18
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10. Arytenoid Cartilage / Fold
11. Laryngopharynx 12. Vestiublar Fold ( False Cord)
13. Vocal Fold (true cord) 14. Glottis
15. Cricoid Cartilage 16. Trachea 17. oesophagus
18. Lingual Tonsils
Posterior Triangle
1-13
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/456/013/q_image_thumb.png?1574615077)
1. parotid 2. Submandib. LNs
3. posterior belly of digastric 4. Submand. Gland
5. SCM 6. Splenius Capitis 7. Levator Scap.
8. trapezius 9. Scal. medius 10. Scal. Post.
11. ECA 12. Facial Art. 13. CCA
posterior triangle
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/456/916/q_image_thumb.png?1574615940)
14. Greater Auricular N. 15. Hypoglossal N.
16. Cervical Plex. 17. Transv. Cerv. N.
18. Brachial Plex (upper trunk)
19. Suprascapular N. 20. Phrenic n.
21. Supraclavicular N. 22. Lesser occipital n.
Accessory N.
i) Course
ii) Innervates
iii) Testing weakness
i) Exits skull vault through Jugular Foramen. Passess deep to SCM and stays near trapezius.
ii) innervates SCM + Trapezium
iii) Trapezius - Shrug
SCM - Resisted turning head (If left turn is weak then contralateral [right] CNXI is damaged)
Parotid Anatomy
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/457/615/q_image_thumb.png?1574616877)
1. Orbicularis Oculi 2. Zygomaticus Major
3. Zygomaticus Minor 4. Levator Angular Oris
5. Orbicularis Oris 6. Depressor ANgular Oris
7. Platysma
8. Masseter 9. SCM 10. Parotid Gland 11. parotid duct (stenson’s) 12. Accessory Parotid gland
13. Superficial Temporal Art. 14. Facial ARtery.
15. Facial Vein 16. Angular Vein
17. Facial N. Upper Div.
18. Temporal N. 19. Zygomatic N. 20. buccal N.
21. Marginal Mandib. N. 22. cervical n.
Clavicle
Label 1 - 6
What ataches 7-15
Name articulation 16-17
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/992/898/q_image_thumb.png?1575063978)
1. Acromial End 2. Ant. Border 3. post. border
4. conoid tubercle 5. shaft 6. sternal end
7. Trap. 8. Delt. 9. SCM 10. Pec Maj.
11. Subclavius 12. Interclavicular lig
13. Trapezoid portion of coroclavicular lig.
14. Conoid portion of coroclavicular lig.
15. Costoclavicular ligament
16. Sternum ARticulation
17. Acromion Articulation
Subclavian Art.
Define the three parts
Branches and where they arise
Branches of the Branches
i) Parts:
1 - origin to scalenus anterior (medial border)
2 - behind scalenus anterior
3 - from lateral borer of scalenus anterior to 1st rib
ii) Branches:
1st Part - Vertebral, Internal Thoracic, Thyrocervical
2nd Part - Costocervical, Dorsal Scapular
iii) B of Bs
Verebtral - Ant. + Post. Meningeal arteries, 1 x Ant spinal artery, 2 x Post Spinal ARtery, PICA (End as they converge to form basillar artery)
Internal Thoracic Artery - terminates as musculophrenic artery + superior epigastric artery
Thyrocervical Trunk - Inf. Thyroid Ard, Suprascapular art., Transverse cervical art., ascending cervical art.
Costocervical trunk - Terminates as deep cervical artery, sup. intercostal art.
Ribs
i) How do they articulate with sternum
ii) Where is the intercostal bundle?
iii) Which rib has 2 tubercles
iv) Describe relations to the scalene tubercle
i) 1-7 - Have individual costal cartilage
8-10 - Have shared costal cartilage
11-12 - have no costal cartilage
ii) intercostal bundle exists in a groove on the lower surface of the rib
iii) First rib - Scalene Tubercle and costal tubercle
iv) Ant. to the tubercle is the groove for the subclavian vein
Post. to the tbercle is the groove for subclav. art. + lower trunk of brachial plexus
Clavicle
Where do the major muscles attaching to the clavicle attach.
Superior Surface:
Acromial End
- Trapezius (posterior)
- Deltoid (anterior)
Sternal End
- Sternocleidomastoid (posterior)
- Pec Major (anterior)
Inferior Sruface:
- Subclavius muscle
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/995/584/a_image_thumb.png?1575066324)
Intercostal
i) Muscles how many are there - name then
ii) Where is the intercostal bundle - name the structures from the top downwards
i) Three
External - Downwards and forwards (inhalation)
Internal - Downwards and backwards (exhalation)
Innermost - Transversus thoracicus (ant.), lateral slips (lat.), subcostalis (post.)
Fibers of internal and external intercostal muscles run in opposite directions.
ii) Run in a groove beneath rib in between the innermost and internal intercostal muscles
(Most Superior) Vein, Artery, Nerve
Label 1-12
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/995/987/q_image_thumb.png?1575066899)
1. Thoracic Aorta 2. Thoracic Duct
3. Ayzgous vein 4. Sympathetic trunk
5. Intercostal Vein, 6. Int. ARt. 7. Int Nerve
8. Sup. Intercostal Vein
9. Vertebral Body 10. Vertebral Disc
11. Rib 12. Innermost intercostal muscle
Label 1-19
![](https://s3.amazonaws.com/brainscape-prod/system/cm/294/996/470/q_image_thumb.png?1575067508)
1. Trachea 2. Inf. Thyroid Vein 3. Trachea
4. R. Main Bronch. 5. L. Main Bronch.
6. Subcarinal LNs 7. Oesophagus
8. Aortic Root 9. Brachiocephalic Trunk
10. Ext. Carotid Art. 11. Subclav. Art.
12. Internal Thoracic ARt. 13. Costocervical Trunk
14. Subclav Art. 15. Common Carotid Art.
16. R Vagus 17. L Vagus 18 R phrenic trunk
19 R Sympathetic trunk
Trachea
i) What level does it originate and divide?
ii) relations of trachea in neck
iii) What are the walls of the trachea made of?
i) Originates at C6 (lower border of cricoid cart.) and divides at T4 (carina is behind angle of louis)
ii)
ant. Thyroid, inf. thyr. vein, sternohyoid, sternothyroid
post. Oesophagus, RLN in oesophagatracheal groove
lat. carotid sheath, lateral thyr. lobes
iii)
Walls of trachea are made of:
- C shaped cartilage anteriorly + laterally
- Membranous wall posteriorly with trachealis muscle
Angle of Louis
i) What vertebral level
ii) What anatomical releavance
i) Level of T4/T5 Vertebrae
ii) Carina, Start+ End of aortic arch
Aygos drains into SVC,
THoracic Duct crosses R -> L behind oesophagus
Division of Sup/Inf Mediastinum
L RLN loops behind aortic arch
Label 1-12
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/001/066/q_image_thumb.png?1575069329)
R Lung
1. Upper Lobe. 2. Lower Lobe 3. Middle lobe
4. Apex 5. Base
6. Horizontal Fissure 7. Oblique Fissure
8. impresion of subcl. art.
9. impression of 1st rib
10. impression of azygous vein
11. Right Atrium 12. Pul Arteries
13. Bronchus 14. Pul Veins
Label 1-13
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/001/478/q_image_thumb.png?1580942173)
1. Upper Lobe 2. Lower Lobe
3. Apex 4. Lingula 5. Base
6. Oblique Fissure
7. Impression for 1st Rib
8. impression for Subclav. ARt
9. Impression for Aorta
10. Impression for L Ventricle
11. Pul. Art. 12. Bronchus 13. Pul Vein
Pulmonary Artery
i) Course of R Pul ARt.
ii) Course of L Pul Art
i) Arise from pulmonary trunk.
Passes in front of oesophagus
behind ascending aorta/ SVC
then at the root it passes between R Main Bronchus and Upper lobe bronchus
Divides into ther branches (lobar)
ii) Arises from PT. Connected to aortic arch by ligamentum arteriosium.
Passes in front of the descending aorta/ L Main Bronchus
i) Describe the pleural cavity
ii) Describe hiccough reflex
iii) Surface markings of pleura
iv) Surface markings of lung
i) Potential space in between visceral pleura (covering the lungs, vessels, bronchi + nerves) and the parietal pleura (attached to the chest wall - endothoracic fascia) .
ii) HIccough is caused by phrenic nerve (+its distribution) irritation leading to contractions of the daiphragm
iii) 2nd rib - are converged and then diverge again at the 4th rib. 6th rib parasternal 8th rib mid clavicular 10th rib mid axillary 12th rib converge
at erector spinae
iv) 6th rib mid clavicular line 8th rib mid axillary line 10th rib Erector Spinae
Lungs
Label
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/082/153/q_image_thumb.png?1575133882)
1. Upper Lobe 2. Midle lobe 3. lower lobe
4. Upper Lobe 5. Lower Lobe 6. Manubrium
7. Diphragm 8. R Lobe Liver 9. L Lobe Liver
10. Falciform Ligament
11. R Apex 12. R Horizontal Fissure 13. R Oblique Fissure 14. L Apex 15. L oblique fissure
16. Int. Thorac. Art. 17. Costal (parietal) Pleura
18. Mediastinal (parietal) pleura
19. Fibrous Pericardium (Superficial to parietal pleura)
20.
Innervation of
Visceral Pleura
Parietal Pleura
Diaphragm
Visceral Pleura - Supplied by vagus nerve
Parietal Pleura - Supplied by intercostal nerves
Diaphragm - Phrenic nerve (C3-C5)
Parietal pleura and diaphragm both have pain receptors whereas the visceral pleura does not.
Diaphragmatic Openings and their occupants, what else goes through diaphragm
Diaphragmatic embyrology - 4 components
i) T8 Caval Foramen (Central tendon)
Contains - IVC + R Phrenic Nerve (L pierces diaphragm directly)
ii) T10 Oesophageal Foramen (R Crus)
Contains- Oesophagus, L Gastric A+V, Vagus trunks
iii) T12 Aortic Foramen (Behind diaphragm)
Contains - Abdominal Aorta, Thoracic Duct, Azygos Vein
iv) L Phrenic Nerve, Splanchnic nerves, Superior epigastric vessels, Sympahetic chain (Behind median arcuate ligament)
Embryologically diaphragm forms from fusion of -
Septum Transversum, Foregut Mesentery, Ingrowth from body wall, Pleuroperitoneal membrane
Septum Transversum forms Central Tendon
Foregut Mesentery forms oesophageal opening + crura
Diaphragm
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/086/631/q_image_thumb.png?1575135742)
1. IVC 2. Oesophagus 3. Aorta
4. Renal Art. 5. Coeliac Art. 6. SMA
7. Pericardiophrenic Art. 8. Inf. Phrenic Art.
9. Costal Fibers of diphragm 10. R Crus
11. L Crus 12. Median Arcuate Lig.
13. Central Tendon 14. Sternal Diaphragm Fibers
15. L Renal Vein
Types of diaphragamatic hernias
Through Bochdalek Foramen - Left usually (through pleuroperitoneal membrane)
Through Morgagni foramen - Anterior through xiphoid and costal origin
Can also herniate through - large oesophageal foramen + through deficient central tendon
Mediastinum
i) Divisions of the mediastinum
i) Imaginary line through the sternal angle seperates the superior (to the thoracic arpeture) and inferior (to the diaphragm) mediastinum.
Superior - Anteriorly - Manubrium to sternal Angle
Posterior - T1 - T4 Vertebrae
Anterior - Between sternal angle and diaphragm (anteriorly chest wall, posteriorly the pericardium)
Middle - Pericardium
Posterior - Anteriorly pericardium, Posteriorly vertebrae, superiorly sternal angle, inferiorly the diaphragm
Contents of:
i) Sup Mediastinum
ii) Ant. Mediastinum
iii) Mid Mediastinum
iv) Post. Mediastinum
i) Vessels- Arch of aorta + branches, SVC + tributaries( Azygos, brachiocephalic, supreme intercost., L Sup. intercostal)
Nerves - phrenic (ant. to ant. scalene), R Vagus (Post. to SVC and R main bronch.), L Vagus (Ant. to Aortic ARch and post. to L Main bronchus), Cardiac Nerves, Sympathetic Trunk
Muscles- Sternohyoid, Sternothyroid
Others- Thymus, Trachea, Oesophagus, Thoracic Duct
ii) Sternopericardial Ligaments (+thymus - mainly in children
iii) Vessels- Ascending Aorta, SVC, Pulmonary Trunk
Nerves - Cardiac plexus, Phrenic Nerves
Others - Heart, Tracheobronchial LNs, Primary Bronchi (+carina)
iv) Vessels - Descending aorta + branches (9 paired post. intercostal, 1-2 Paired bronchial arteries, 1-2 unpaired oesophageal arteries, Sup. phrenic arteries), Azygous System
Nerves - L+R Vagus Nerves ( form oesophageal plexus and then as leaving diaphragm converge to form L+R Vagal Trunks), Sympathetic Trunks
Others - Oesophagus (posterior to aortic arch / aorta), Thoracic Duct (Anterior to vertebral bodies),
Describe Azygous System
Importance in IVC Obstruction?
In the posterior mediastinum:
Azygous vein - Formed from R Lumbar + R Subcostal veins. Enters with aorta through aortic hiatus.
Essentially drains the posterior lumbar and thoracic wall
Hemiazygous vein - Formed from L Lumbar L subcostal vein. Enters through L crus of diaphragm. At T8 crosses vertebrae and drains into ayzous vein.
Accessory Hemiazygous Vein - Formed from L 4th-8th intercostal veins. Crosses at T7 to drain into Azygous Vein.
The ayzgous vein empties into the SVC by passing over the R Main Bronchus at the root of the lung.
IVC obstruction - There is collateralisation through the azygous system to the SVC through:
Lumbar Azygous Veins (between renal veins and azygous veins) which form communication between IVC and azygous vein (at its origin)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/094/993/a_image_thumb.png?1578156216)
Heart Anterior
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/095/411/q_image_thumb.png?1575141601)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/095/411/a_image_thumb.png?1575141714)
Heart Vasculature:
i) How many Pulmonary Veins are there?
ii) SVC Course?
iii) What is the coronary sulcus?
iv) what are the interventricular sulci?
v) What are the pericardial sinuses?
i) 2 Pairs of pulmonary veins - 1 inferior + 1 superior
all draining into L Atrium
ii) SVC formed by unification of both brachicephalic veins. The SVC travels laterally to the right mediastinum and then pierces the middle mediastinum before emptying into the right atrium.
iii) Groove running circumferentially around the heart ‘seperating’ the atria from the ventricles
iv) Running vertically down the surface of the anterior + posterior aspcts of heart
v) Sinuses are formed from folds of the pericardium.
oblique sinus - on posterior surface of heart
trasnverse sinus - Posterior to the ascending aorta + pulmonary traunk / Anterior to the SVC. Seperates the main arteries/veins
Heart anatomy atria :
i) Divisions of R Atrium
ii) what is the fossa ovalis a remnant of?
iii) gross description of L atrium
i) Divided by the crista terminalis (muscular ridge) into the sinus venarum (posterior to CT) and the atrium proper (anterior to CT) which has pectinate muscles. Coronory Sinus also opens into the right atrium
ii) Fossa Ovalis is a remnant of the foramen ovale in between the R and L atriums on the interatrial
septum.
iii) Posterior border of the heart. Superiorly is the l auricle. Two portions of the L atrium (interior) - posterior is the inflow portion receiving blood from PVs and the anterior is the outflow portion which is lined by pectinate muscles.
Heart Anatomy (Ventricles):
i) Different features of ventricle walls
ii) How many papillary muscles on R ventricle / L VEntricle
iii) What are the outflow tract of R and L Ventricle called
i) Trabeculae Carnae - are a series of muscular elevation predominantly in inflow tracts. Different types are -
Papillary Muscles - are attached to the tricuspid/mitral valve by Chordae Tendinae. They contract to prevent valve prolapse during ventricular systole
Ridges + Bridges (Important example of a bridge is the moderator band of R Ventricle)
Supraventricular Crest - Divides inflow and outflow portion of the R Ventricle
ii) 3 - on right as tricupid has 3 leaflets
2 - on left as mitral has 2 leaflets
iii) Conus Arteriosus - is the outflow tract of the R Ventricle where as the L Vetnricle outflow tract is called the aortic vestibule. Both develop from the bulbus cordis.
Cardiac Conducting System
i) Where is SA node
ii) What is the PR interval caused by?
iii) What happens beyond the AV node? Describe the components
iv) Where might you find pacemaker leads?
i) Sinoatrial Node is in the wall of right atrium near the SVC
ii) PR interval is caused by delayed conduction in the atrioventricular node situated in the atrioventricular septum near the coronary sinus
iii) Immediately after the AV node is the bundle of his within the interventricular septum. This then branches into the Right and Left Bundle.
Right Bundle - Only 1 Fascilce
Left Bundle - Anterior and Posterior fasicle.
The bundles then continue to the apex of the heart from where purkinje fibers begin to extend into the subendocardium disseminating action potential to myocardium.
iv)
Right ventricle lead - practically all devices
Right atrial lead - dual chamber devices
Coronary Sinus lead - Biventricular devices
Pericardium
i) Layers
ii) innervation
i) Fibrous Pericardium - Continuous with central tendon of diaphragm. Non distensible
Serous Pericardium - Seperated into -
Parietal Pericardium
Visceral Pericarium - Also known as the epicardium
ii) Innervated by the phrenic nerve
Coronary Vasculature
i) Describe the coronary arteries
i) Aortic Sinuses are behind the aortic valve leaflets and blood enters this in diastole.
Aortic Sinuses go on to form the:
Left Coronary Artery + Right Coronary Artery
Left coronary artery gives three branches(or four):
Left Anterior Descending (Anterior Inteventricular groove. AKA Anterior Interventricular Artery)
Left Circumflex ARtery (In the coronary sulcus. Gives rise to the L Marginal Artery)
(rarely the posterior interventricular artery)
Right Coronary artery (runs in the coronary sulcus) gives two branches (or one):
Right Marginal Artery
Posterior Interventricular Artery (Post. IV Groove)
ii) Veins eventually drain into the coronary sinus (located posteriorly on the coronary sulcus which in turn drains into the R atrium )
Anterior Veins are the :
Great Cardiac Vein - In anterior interventricular groove
Small Cardiac Vein - Right Sided
Posterior vein is the :
Middle Cardiac Vein
Left Marginal Vein
Left posterior ventricular vein
Heart B
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/177/880/q_image_thumb.png?1575216044)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/177/880/a_image_thumb.png?1575216079)
Label 1 - 16
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/180/152/q_image_thumb.png?1575217095)
1. Iliac Crest 2. Iliac Tubercle 3. ASIS
4. Gluteal Fossa 5. Body of Ilium
6. Lunate surface 7. Acetabular Fossa
8. Acetabular Notch 9. Ischial Tuberosity
10. Ischial Body 11. ischial spine
12. AIIS 13. Iliac Fossa 14. Iliac Tuberosity15. PSIS 16. PIIS
Label 17-32
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/181/974/q_image_thumb.png?1575218218)
- Arcuate Line
18. Iliopubic eminence 19. Pubic tubercle
20. pubic crest 21. pubic symphysis
22. Inf. Pub. Ramus 23. Ischial Ramus
24. Obturator Crest 25. Lesser Sciat. Notch
26. Greater Sciat. Notch
27. Groove for obturator Externus
28. Post. Gluteal Line 29. Inf. Gluteal Line
30. Ant. Gluteal Line 31. Obturator foramen
32. Obturator groove
Greater Sciatic Foramen
i) Boundaries of greater sciatic foramen
ii) Structures passing through the GSF
i) Anterolateral - Greater Sciatic Notch of ilium
Posteromedial - Sacrotuberous ligament
Inferior- Sacrospinous lig and ischial spine
Superior - Ant. Sacroiliac ligament
ii) Piriformis runs through and ‘divides the GSF’
Total - 7 nerves, 3 Vascular Sets + Piriformis
Above Piriformis
Superior Gluteal Vessels + Nerve
Below Piriformis
Vascular - a) Inf Gluteal Vessels b) Int. Pudendal vessels
Nerves - a) Sciatic Nerve b) Inf. Glut. Nerve
c) Pudendal Nerve d)Post. Fem. Cutaneous Nerve
e) Nerve to obturator Internus
f) Nerve to quadratus femoris
i) Blood supply to the hip joint
ii) Attachment of capsule to the femur
iii) Extracapsular/Intracapsular hip ligaments
i) Principally three arteries:
Medial Circumflex Femoral Artery (largely)
Lateral Circumflex Femoral Artery
Artery to head of femur (branch of obturator artery with minor contribution)
Medial and lat circ branch of profunda femoris artery
ii) Has both ant. and post. femoral attachment
Ant. - Intertrochanteric Line
Post. - More proximal on femoral neck
iii) Iliofemoral Ligament -AIIS ->Intertrochanteric line
Pubofemoral Ligament - Superior pubic rami -> Intertrochanteric Line (triangular shape)
Ischiofemoral Ligament - Body of ischium -> Greater trochanter (Spirals)
Femur Anatomy
Label 1-11
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/184/224/q_image_thumb.png?1575219794)
Attachment for:
1. Gluteus Minimus 2. Piriformis 3. gluteus medius
4. Quadratus Femoris 5. Iliopsoas 6. Glut. Max.
7. Vastus Lateralis 8. Vastus Medialis
9. Obtur. Internus + Gemellae
10. Iliofemoral lig. 11. Lig. Teres
Name Muscles:
i) Flexing hip point
ii) Short external rotators
iii) Abducting the hip joint
i) Iliopsoas, Pectineus, Sartorius, Rectus Femoris
ii) Superior to Inferior. Piriformis, Sup. Gemelli, Obt. int. + Ext., Quadr. Fem.
iii) TFL, Glut. Med + Min
Iliopsoas
Origin
Insertion
Innervation
Origin - Iliac Fossa, T12 - L5 vertebrae
Insertion - lesser trochanter
Innervation - Femoral Nere (+L1-L2)
Origin, Insertion + Inneration of
Glut. Med, Min + TFL
Innervated - Superior Gluteal Nerve (L4-S1 Sacral Plexus)
Glut Med + Min -> Glut Fossa of Ilium -> Greater trochanter
TFL -> Iliac Crest -> IT Band
Gluteal Region
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/295/862/q_image_thumb.png?1575309369)
Label Muscles 1-8
Origin 9
Fascia 11-12
Ligament 13
Structures 14-16
Label 17-24
1. Glut. Max. 2. Glut Med. 3. Glut. Min.
4. Piriformis 5. External Obliq. 6. Obt. Extern
7. Obt. Int./ Gemellae 8. Levator Ani
9. Hamstring Origin 10. Iliac Crest
11. Gluteal Fascia 12. Lumbar Fascia
13. Sacrotuberous ligament
14. Ischial Tuberosity 15. Greater Trochanter
16. Hip Joint Capsule 17. Sup. Glut. Art.
18. Sup. Glut. Nerve. 19. Inf. Glut. Nerve
20. Inf. Glut. ARt. 21. Post. Cut. Nerve of thigh
22. Sciatic Nerve (L4-S3) 23. Inf. Rect. Nerve
24. Cutaneous branches of lumbar dorsal rami
Sciatic Nerve
i) Roots
ii) Course
iii) Innervates
i) L4-S3
ii) Ventral Rami L4-S3. Leave pelvis through GSF below piriformis. Travels beneath glut max traversing inferiorly between the greater trochanter and ischial tuberosity.
Travels superficially to adductor magnus before enterring poplital fossa.
iii)
Hamstring Muscles
Adductor Magnus (tibial portion)
External Rotators (Gemellae, Obt. Internus, Quad. Femor.)
Then –>
Common Peroneal Nerve : Ant. + Peroneal comparments
Tibial nerve: Deep and Superficial Posterior Compartments
sensation to posterior thigh and lateral leg
Post. Knee.
Label
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/298/113/q_image_thumb.png?1575312391)
1. Med. Fem. Condyle 2. lat. Fem. Condyle
3. Fibular Head 4. Med. Meniscus 5. Lat. Meniscus
6. Post. Meniscofem. Lig 7. Post. Cruc. Lig
8. popliteus 9. Lat. Collateral Lig.
10. Prox. Tibiofibular Joint 11. Femur 12. Patella
13. Tibia 14. Fat Pad 15. Quadriceps Tendon
16. patella tendon 17. Suprapatellar bursa
Knee Label 2
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/300/391/q_image_thumb.png?1575313069)
1. Lat. Fem. Condyle 2. patella 3. Tib. Tuberosity
4. Quad. Tendon 5. Patel. Tendon
6. Lat. Meniscus 7. Lat. Colat. Lig
8. Bicep Femoris (Reflected inferiorly)
9. Popliteus 10. Lat. Head of gastroc. + plantaris
11. Tibial Nerve 12. Common Peroneal Nerve
13. Med. Fem. Conyle 14. Vastus Medial.
15. Hamstring tendon portion of add. magnus
16. Adductor Tubercle 17. Gracilis 18. Sartorius
19. Semitendinosis 20. Pes Anserina
21. Medial Gastrocnemius 22. Tibia
23. Med. Collat. Lig. 24. Adductor Hiatus
Knee Joint (Left)
Label 1-14
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/300/408/q_image_thumb.png?1575312368)
1. Patella Groove 2. Sup. Lat. Fem. Condyle
3. Sup. Med. Fem. Condyle 4. Med. Fem. Condyle
5. Lat. Fem. Condyle 6. Med. Tib. Condyle
7. Lat. Tib. Condyle 8. intercondylar eminence
9. Tib. Spine 10. Intercondylar Notch
11. ACL 12. PCL 13. Lat. Meniscus 14. Med. Meniscus
Where do they attach:
i) ACL
ii) PCL
iii) MCL
iv) LCL
v) Which nerve/artery is commonly injured in knee dislocation?
i) ACL - Lat. Condyle of femur -> Anterior intercondylar area
ii) PCL - Med. Condyle of femur -> Post. intercondylar area
iii) MCL - medial epicondyle of femur -> med tibial condyle
Part of the MCL directly communicates with the medial meniscus
iv) LCL - lateral epicondyle of femur -> fibular head
seperate from lateral meniscus
v) Common peroneal nerve - roughly 15%
Popliteal Artery - roughly 10%
Popliteal Fossa:
i) Boundaries
ii) Contents
iii) Where do the Popliteal LNs drain?
i) Superior
Lateral - Bicep Fem
Medial - Semi memb/tend
Inferior
Med/Lat - Gastrocnemius
Roof - Fascia Lata
Floor - Post knee joint capsule + poplitues musc.
ii) Contents: (superficial to deep)
Nerves (most superficial) - Common peroneal nerve - Medial to bicep fem tendon.
Tibial Nerve - Crosses from lat. side of vessels to medial
Post. Cutaneous nerve of thigh - Medial
Pop. Vein (+lesser saphenous) then Pop. Artery
iii) Popliteal LNs drain the venous distrubiton of SSV
Popliteal Region
1-17
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/372/897/q_image_thumb.png?1575378805)
1. Semimembranosis 2. Biceps Fem
3. Semitendinosis 4. adductor magnus
5. plantaris 6. med. Gastroc. head
7. lat. gastroc. head 8. IT Band 9. Adductor Hiatus
10. Pop. Vein 11. Pop. Art. 12. Tib. Nerve
13. Common Peroneal Nerve
14. Med. Head Gastroc. Nerve 15. Sural Nerve
16. Sup. Lat. Genicular Artery
17. inf. lat. Genicular art.
Describe lower limb blood supply
Femoral artery - Continuation of external iliac artery becoming the femoral artery as it passes beneath the inguinal ligament to enter the femoral triangle. Beyond the femoral triangle it descends in the adductor canal.
Profunda femoris artery is a posterolateral branch of the femoral artery. In turn it gives off 3 main branches - Med and lat fem circumflex arteries and then some perforating muscular branches.
Obturator artery - arises from internal iliac artery and enters medial thigh through the obturator foramen. Supplies medial thigh compartment / deep gluteal muscles
Popliteal artery (discussed further below) - gives off 3 medial and 2 lateral genicular arteries
Lower Leg
Superficial femoral artery becomes Popliteal artery as it exits the adductor hiatus and enters popliteal fossa.
Just inferior to the popliteal fossa it bifurcates:
Anterior Tibial Artery - Becomes the dorsalis pedis artery in the foot (passes anteriorly beneath extensor retinaculum)
Tibioperoneal trunk -which then birfucates into the: posterior tibial artery passing posterior to medial malleolus
peroneal artery
The Leg Bones
Structures 1-9
Attachments 10 - 21
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/374/921/q_image_thumb.png?1575380769)
1. med. tib. condyle 2. lat. tib. condyle
3. tib. tuberosity 4. Med. surf. tibia
5. fibular neck 6. fib head 7. Tibial Spines
8. Popliteal surface of tibia 9. Soleal line
10. Semimembranosis 11. patella tendon
12. Bicep Fem. 13. Soleus 14. Popliteus
15. Semitendin. 16. Gracil. 17. Sartorius
18. Pes Anserina 19. Med. Colat. Lig
20. Lat. Colat. Lig 21. IT Band
Lower Limb Compartments, blood supples, muscles, nerves
i) Anterior Compartment
Deep peroneal nerve/ Anterior Tibial Artery
Anterior Tibialis, Extensor Hallucis Longus, Extensor Digitorum Longus, Peroneus Tertius
ii) Peroneal Compartment
Superficial peroneal nerve/ Peroneal Artery
Peroneus Longs, Peroneus Brevis
iii) Superficial Posterior Compartment
Tibial Nerve/ Posterior TIbial Artery
Gastrocnemius, Soleus, Plantaris
iv) Deep Posterior Compartment
Tibial nerve/ Posterior Tibial Artery
Tibialis Posterior, Popliteus, Flexor hallucis longus, flexor digitorum longus
Surface markings of foot
Label
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/378/426/q_image_thumb.png?1575384121)
1. Lateral Malleolus 2. Medial malleolus
3. Tibialis Ant. 4. Extensor Hallucis Longus
5. Extensor Digitorum Longus
6. Extensor Digitorum Brevis
Structures running
- posterior to medial malleolus
- anterior to medial malleolus
Posterior to med. malleolus:
Ant. -> Post (Tom, Dick + Very Nervous Harry)
Tib. Post
Flexor Digitorum Longus
Post. Tibial Art.
Post. Tibial Vein
Tibial Nerve
Flexor Hallucis Longus Tend.
Anterior to medial malleolus :
Long saphenous vein
Foot - Label
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/379/124/q_image_thumb.png?1575384377)
1. Med. Malleolus 2. lat. malleolus 3. Tib. Anterior
4. Extensor hallucis longus 5. Extensor Dig. Long.
6. Extensor Dig. Brev. 7. Peroneus Brev.
8. Peroneus Tertius. 9. Extens. Halluc. Brevis.
Foot skeleton - label bony landpoints 1-25
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/379/563/q_image_thumb.png?1575384669)
1. Calcaneus 2. Talar Dome
3. Talar Neck 4. talar head 5. Navicular
6. Cuboid 7. Lateral Cuneiform
8. Intermediate Cuneiform 9. Medial Cuneiform
10. 1st Metatarsal 11. 3rd Metatarsal
12. 5th Metatarsal 13. Distal Phalanx 14. Proximal Phalanx 15. Distal phalanx 16. Middle Phalanx
17. Proximal phalanx 18. 1st metatrsal head
19. 1st metatarsal shaft 20. 1st metatarsal base
21. Ant. Tuberc. Calcaneus 22. Substentaculum Tali
23. Lateral process of calcaneus
24. Medial Tubercle of Talus
25. Lateral Tubercle of Talus
26 - Name the fracture
27-29 - Tendons traversing groove
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/381/254/q_image_thumb.png?1575385537)
26. Jone’s Fracture - diaphyseal 5th metatarsal
27 + 28. Flexor Hallucis Longus
29. Peroneus Longus
i) Anatomical Divisions of foot
i) Forefoot - MTs + Phalanges
Midfoot - Cuboid, Navicular + Cuneiform Bones
Hindfoot - Talus + Calcaneus ( True anle joint is between talus and tib/fib. Subtalar Joint between talus + Calcaneus)
Foot Ankle Label
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/381/988/q_image_thumb.png?1575386314)
1. Medial Malleolus 2. Calcaenus 3. lateral malleolus
4. Navicular 5. Medial Cuneiform
6. 1st metatarsal 7. talar dome
8. Cuboid 9. 5th metatarsal
10. Achilles Tendon (common tendinous insertion of gastrocnemius, plantaris + soleus)
11. Deltoid ligament 12. Posterior talo-fibular ligm.
13. Calcaneofibular ligament 14. Anterior talo-fibular ligament. 15. Long Plant. Ligament
16. Peroneus Brevis
Structures running posterior to lateral malleolus and where they go in the foot.
Peroneus Brevis - (From fibula) to 5th metatrsal (alongside peroneus tertius)
Peroneus Longus - (More proximally on fibula) to 1st metatarsal
Describle ankle ligmanets
Medially: Deltoid ligament
This spans from the medial malleolus (tibia) to
i) substentaculum tali ii) calcaneonavicular lig.
iii) navicular tuberosity iv) medial talus
Laterally: Three Ligaments
Anterior Talofibular Ligament (Lateral Mal. of fib to ant. talus)
Posterior Talofibular Ligament (Lateral Mal. of fib to
post. talus)
Calcaneofibular ligament (Lateral Mal. to Lat. Calcan.)
Syndesmotic:
Anterior + Posterior Inferior Tibiofibular ligaments
What is the angle between the femoral neck and the femoral shaft
125 degrees
What type of bone is the patella?
The patella is a sesamoid bone
Label A-H
![](https://s3.amazonaws.com/brainscape-prod/system/cm/295/501/624/q_image_thumb.png?1575471624)
A. Vastus Medialis
B- Sartorius
C- Gracilis
D - Medial Gastroc
E/F - Semintendinosis
G - Rectus Femoris
H - Adductor Magnus (Hamstring Portion)
Attachments of cruciate ligaments
Anterior Cruciate Ligament - Anterior tibia to lateral intercondylar notch of femur
Posterior Cruciate Ligament - Posterior tibita to medial intercondylar notch of femur